title: Diagnostic accuracy of circulating tumor cells detection in gastric cancer: systematic review and meta-analysis.
abstract: BACKGROUND
  Circulating tumor cells (CTCs) detection has previously been used for diagnosing gastric cancer. However, the previous studies failed to make an agreement whether the detection of CTCs contributes to the diagnosis of gastric cancer.
  
  
  METHODS
  A systematic review and meta-analysis was performed to evaluate the overall accuracy of CTCs detection for diagnosing gastric cancer. PubMed, Embase and the Wanfang database were searched in all languages published up to Oct 2012. The pooled sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR) and summary receiver operating characteristic (sROC) curve were calculated to evaluate the overall test performance.
  
  
  RESULTS
  Twenty studies were included in this systematic review and meta-analysis. The diagnostic value of CTCs detection for the gastric cancer was calculated to evaluate the overall test performance. The summary estimates of The pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio were 0.42 (95% confidence interval (CI), 0.21-0.67), 0.99 (95% CI, 0.96-1.00), 58.2 (95% CI, 9.8-345.9), 0.58 (95% CI, 0.38-0.89), and 100 (95% CI, 15-663), respectively. The summary receiver operating characteristic curve was 0.97 (95% CI, 0.95-0.98). Deek's funnel plot asymmetry test found no evidence of study publication bias in the current study (P = 0.49).
  
  
  CONCLUSIONS
  This systematic review suggests that CTCs detection alone cannot be recommended as a screening test for gastric cancer. However, it might be used as a noninvasive method for the confirmation of the gastric cancer diagnosis.
authors.affiliation: Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Lanhua
authors.initials: L
authors.lastname: Tang
authors.forename: Shushan
authors.initials: S
authors.lastname: Zhao
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Nicholas F
authors.initials: NF
authors.lastname: Parchim
authors.forename: Jin
authors.initials: J
authors.lastname: Huang
authors.forename: Youhong
authors.initials: Y
authors.lastname: Tang
authors.forename: Pingping
authors.initials: P
authors.lastname: Gan
authors.forename: Meizuo
authors.initials: M
authors.lastname: Zhong
mesh_terms: D019540:Area Under Curve; D016001:Confidence Intervals; D006801:Humans; D016013:Likelihood Functions; D009360:Neoplastic Cells, Circulating; D016017:Odds Ratio; D012372:ROC Curve; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis*